HomeMy WebLinkAbout1003 E UNION ST_035543_2026 C I TY OF ARL I P4C3-rUP4
COh1ST RUGT I Ohl F>E RM I T
l:>E F2M I T h40_ _ GD3—'ES 543
Owner: BENNETT, CARRIE PO BOX 354 ARLINGTON 98223
Value of Work: $2, 000. 00 Tax ID: Phone: 360. 435. 3838
Describe Work: REMOVES EXISITING SHINGLES AND REPLACE W/METAL
Proposed Use: SFR
Legal Description:
Job Address: 103 E UNION
Contractor's Name Type Address License*
OWN
TOTALS Fee
Permit Fee $50. 00
State fee $4. 50
SIGNATURE: C., x/tA ` '�""' `P L
TOTAL FEE. . . . . . . . . . . . . . . . . $54. 50 I HEREBY CERTIFY THAT I HAVE READ
AND EXAMINED THIS APPLICATION AND
PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNOW THE SAME TO BE TRUE AND COR-
RECT ALL PROVISIONS OF L S AND
TOTAL DUE. . . . . . . . . . . . . . . . . $54. 50 ORDINANCES GOVEMING . HI T PE OF
WORK ILL B COMPLIFD WI H' HETHER
S EC rED Ef REIDDYY OR T
DATE RECEIPT #
H I ING OFF IAL
� sJ� L� 7117 �
3
2y� a4 � l�Ile-_
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CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ COMBINATION Ad BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.
QWNE �j MAIL ADDRESS CITY ZIP PHONE
CB/ �t✓LC�/ fJ_✓ di7W
ARCFATECT OR DESIGNER MAIL ADDRESS CITY LIP PHONE
CyENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
V/ Fa m:I v
MECHANICAL¢ONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF
PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
CLASS OF WORK
❑NLW ❑ADDITION ALTERATION ❑REPAIR ❑DEMOLI PION ❑BUILDING RELOCATION
VALUATION OF WORK
f
DESCRIBE WORK / nn
? I V l LJ 1
PROPOSE U USE OF BUILDI G
I HEREBY CkRTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
LLGAL ULSCRIPTION Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
LOT-BLOCK - OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO
VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
/TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
v CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE
10 AUURI SS 7
1,7&3 E' l�l�r O�(� X ri -
(OFFICE USE ONLY) MECHANICAL
PLUMBING
NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT SEE
WATER CLOSET (TOILLI) y AIR COND. UNITS —H.P. EA.
BAIFIIUB REFRIGERATION UNITS—H.P. EA.
LAVATORY (WASH BASIN) BOILERS- H P. EA
SHOWLR GAS FIRED AC. UNITS—TONNAGE EA.
KI ICHLN SINK& DISP. FORCED AIR SYSTEMS— B T.U. A
DISHWASHER Y WALL HEATERS—B.T.0
LAUNDRY TRAY UNIT HEATERS— B.T.U.
CLOI IILS WASHLR EVAPORAI IVE COOLERS
WA ER BEATER CLOTHES DRYERS
URINAL VENTILATICN FAN
DRINKING FOUN I AIN RANGE HOOD COMM RCIAL
FLOOR DRAIN AIR HANDLING U — CPM
VACUUM BREAKERS STOVE
ROOF DRAINS RAItAADERS METAL FIREP ACE &CHIMNEY
SINK (SERVICE - R,ETC) WATER HEATER
GAS PIP AG
SUBTOTAL f SUBTOTAL f
PERMIT f PERMIT f
TOTALFEE $ TOTAL FEE f
SIDL YARD SL 1 BACK STRELI SL IBACK REAR YARD BACK PLAN CHECK NUMBER PLAN CHECK FEE
FEE RECEIPT NO.
USE LONE LOT AREA 'VACANT SITE
❑ FEES VALUATION FEE
❑YES NO
TYPE OF CONS1 OCCUPA ROUP NO.OF DWELLING UNITS PLAN CHECKING VG
BUTDING f
SIZE Of BLDG. NO.Of STORILS MAX.OCC.LOAD
PLUMBING
FIRE SPRINKLERS REQUIRED
❑YES ❑NO MECHANICAL
STATE BLDG.CODE
COMMENTS ENERGY CODE SURCHARGE
PENALTY SEC.
S 303(a)
WATER/SEWER FEES
TOTAL
PERMIT VALIDATION
WHEN PROPERLY VALIDATED TIN THIS SPACEI THIS IS YOUR PERMIT&RECEIPT
PAID CR# BY —
BUILDING OFFKUL DATE
cc: ASSESSOR,APPLICANT,TREASURER, BLDG DEPT RECORDS COPY